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Drugs, Drugs, Glorious Drugs (With Apologies to Flanders and Swann). Wednesday November 30, 2016

Just to the north of where I live is fen country.

Here the land stretches, further than the eye can see, without mountains, without hills, without even the slightest incline. Here is utter flatness under a vast East Anglian sky.

Today I am travelling north to give a talk to a ladies' charity luncheon. I take the road called Sixteen Mile Bank. Bank, because it travels along the side of one of the large fenland waterways which cut, ruler straight, through the fenland fields; Sixteen Mile – well, I'll let you guess.

This land may be flat, but to me it is beautiful. Today a late November sun is shining from a limpid sky, gilding the bare green rods of willow and flicking lights on the water so it flashes blue and silver and deepest mossy green.

A kestrel hangs unmoving in mid-air, suspended like an illusionist's trick. On the far side of the water a heron, statue-still, is a poem in platinum and steel against the greyed frost of the grass and water reeds. The light picks out a pair of swans, incandescent in their bright white and in the field beside me two horses are being lunged. Their chestnut coats gleam in the sun and their hooves make circular patterns on the ground like an intricate Spirograph.

My soul lifts and I feel joy. I want to share this beauty with someone.

So I'll share it with you.

Last week, there would have been no beauty and no joy. If I had driven this road and observed the sun, the sky, the birds, the water; it would have been an "Oh yes, a kestrel. A heron. Swans. Horses." There would have been no colour and no dancing light.

It is not because I am better that the light and colour have returned, but because of Citalopram (an antidepressant drug). Because of Citalopram I only have to spend a couple of weeks in the utter darkness before I am restored to the point where basic functionality at least is regained, where I actually wish to carry on living.

Before I gave in and accepted that medication might help, I had to cope with the black for months on end. Even then I had to try more than one type of antidepressant before I found one that worked.

And yes – I still have to be careful. After the talk I have to go home and sleep for a couple of hours. The journey home is done on autopilot and I remember nothing about Sixteen Mile Bank except the sensation of my hands gripping tight to the steering wheel, because driving that close to the mesmerising water is dangerous. Every year we lose people to the cold and dark fenland drains.

But at least, this week, I don't want to be among the number of those lost.

I am so very thankful for the drugs.

A Moodscope member.

Thoughts on the above? Please feel free to post a comment below.

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doug Wed, Nov 30th 2016 @ 5:09am

thank you Mary.. have read about the fens but never seen them, enjoyed your writing. Waterscapes make me happy.
I'm so glad I was already on drugs when this election hit.

Mary Wednesday Wed, Nov 30th 2016 @ 6:17am

Thank you Doug, your comment made me smile. I am guessing you are accross the pond? I am so pleased I didn't have a vote in your election....

Karen Wed, Nov 30th 2016 @ 8:01am

Thank you all, I am reminded of three thinks reading Marys thoughts -Anti depressant resistance is very high and finding the 'right one for you' can take years of perseverance and determination and I like you have finally found one for me after nearly 20 years. Part of it is new drugs on the market but it is also a factor of another thought. -When I nursed many years ago we had a cliché - which was 'prescribing is an art not a science' for the Dr. Yes they have the BNF with all its prescribing guidelines and research but as I sit in front of them asking for help, they have no knowledge ' how I specifically will respond to it' and that at times paralyses them as they can't 'fix me'. Just like they can't keep all their patients alive. The NHS is so strapped for money often drugs are their only choice as there is so little budget for non medication based therapies. -Finally thank you for reminding me that 'stopping and smelling the roses' or the view of the passing road is important on my road to recovery. Thanks Mary

doug Thu, Dec 8th 2016 @ 6:26pm

yes, South African now living in US.. grew up in a police state, moved out of it, did not expect the US to go down the same racist Nazi-sympathizer path as South Africa did. I was going to try to get off the drugs in spring, suspect instead will need to increase the dose.. "nothing quite like 'em for cooling the blood"

Perola Wed, Nov 30th 2016 @ 6:16am

good morning Mary, you write so eloquently and so beautifully. I too have had periods of darkness, fear, anxiety. I love reading the blogs, and am struck by how some of the regulars articulate what I am also feeling.

Mary Wednesday Wed, Nov 30th 2016 @ 7:05am

Thank you Perils. It's good to know we are not alone isn't it! Even if we would not wish this affliction on anyone.

Mary Wednesday Wed, Nov 30th 2016 @ 7:06am

So sorry - autoerror changed your name, Perola and I didn't catch it before posting my reply!

DAVE Wed, Nov 30th 2016 @ 7:09am

Hi Mary,
Such empathy, so in tune, so eloquent, so mindfully aware of your surroundings, thank you, I felt as though I was a passenger in your car ! !

Now....If your mind focuses so acurately, so acutely upon that which surrounds you, so much much more than Mr and Mrs Average.....Then it, to me sounds quite acceptable that upon returning home the same're exhausted, ''Wiped Out'. !

Delving into your personal lifestyle, if that same amount of energy is projected, aim at, and implemented in ALL other facets of your daily routine, then my previous blog, might well have been right, that your type of Bipolar, and how it is managed is 'Off Centre', in that you may well be coping.......or NOT...Just on the parimeter, the boundary of 'Normality' and 'Depression'.

You see my Doctor for years, like most Doctors, treat!the 'symptoms' of Bipolar, and MAYBE NOT the cause. He knew nothing about....How many Plates that I was 'forced' to keep in the air at the same time..£106,000 Mortgage, three kids, my wife, my business (Sales &Service) which I ran alone from home ! Subcontracting engineers to service and repair the products I sold, assembling desks, furniture, selling Photocopiers and all associated offices machines, I did all the buying assembling, and selling.

My wife ran an international B & B whose patriots came to stay from worldwide locations etc etc.

Now Nary if you're of similarly occupied....Is it NOT surprising, that you too may also be 'burning the candle at both ends'. ? ?

AGAIN only my opinion, based upon that which in your BLOGS dictates, and your CLINGING on to a Drug, would indicate a dependence upon an artificial source which 'SEEM'S' to you to resolve TEMPORARILY some resemblance, of a 'Glimpse ' of your idea of NORMALITY !

My blogs are always empathetic in that I am sharing my thoughts which I put into practice and work better than others' may anticipate.

My love and heart goes out to you Mary and you really are a shinning example to us how much of a GIVER you really are.

God Bless.
Dave X

LP Wed, Nov 30th 2016 @ 7:47am

I was swept away into your world by your writing too Mary.
I'm so glad for you that you have found the right medication for you that prevents the suffering from going on. Thank you for a beautiful blog. Hugs to all. LPxx

Anghared Wed, Nov 30th 2016 @ 7:48am

I have just finished reading your most beautiful piece of writing. I have never ventured over to your side of our tiny island, I live in Dorset a short walk to the Jurassic coast with all its magnificent seas just on my doorstep, I can smell the sea in the morning when I go outside, and this most of the time grounds me and I stop and breath in that clear crisp air, which certainly, well most of the time helps my lurching, sickening bouts of anxiety that overwhelms from time to time, what a nuisance it has become.

I want to be over on your 16 mile Fenland path right now, and to experience all that natural beauty you have described, I was with you on your journey going and the exhausted one coming back.

I also have succumbed to medication, which has helped me, if it enables us to function so be it.

Thankyou to a lovely start to my day, I feel uplifted and positive, the day is good and I will embrace it with a sharpened sense of mind.

Life is good. Thank you.


Tutti Frutti Wed, Nov 30th 2016 @ 8:23am

Hi Mary
It's good to see you are so much better and back to appreciating the things around you. I thank God that he has created people with the ingenuity to make these drugs to limit the suffering and pray that future research will enable them to find the right drugs for more of us in a less hit and miss way and with fewer side effects. It was lovely to read your description of the fens today. Not an area I have been to and it had always sounded a bit bleak to me but your description made it sound beautiful. It's a shame that you are still finding the journey back so tough. Perhaps it would be a good idea to stick to lifts whenever possible until you are a bit further into your recovery. Love and hugs TF xoxo

silvia Wed, Nov 30th 2016 @ 9:03am

Thank you Mary, I'm also on Citalopram, it is exactly like you describe, the beauty and colours that appear and disappear according to our state of mind. Like many, I also had trouble accepting taking drugs, but now I feel I should have done it much earlier and am strictly sticking to them, although on a low dosage.

Tutti Frutti Wed, Nov 30th 2016 @ 9:25am

Just a message for Jul that I have tried to clarify my comments on yesterday's blog as I think from your response that I didn't explain myself very well. Love TF x

Jul Wed, Nov 30th 2016 @ 10:32am

Hello Tutti Frutti. Thank you for your explanation which I have just read. You did explain yourself perfectly well. The trouble with me is that I tend to take what I want to out of what I'm reading! So it's not necessarily what the writer intended or meant. I do understand now what you were saying about sleep. I have a very complicated relationship with sleep and yet your take on it in the context of bi polar was something I'd never thought of before. When I have prolonged periods of not sleeping deeply, I run on adrenaline which cannot be good for my physical health. So much so that when a good night happens, I feel absolutely dreadful physically the next day(usually) as my body isn't used to being totally relaxed for a few hours (deep sleep). Mentally I feel high but my body drags!. I am sorry I made you explain further Tutti Frutti. I always read your comments with interest and your explanation today was very helpful. I hope you are feeling good today. Love Jul xx

Tutti Frutti Wed, Nov 30th 2016 @ 4:45pm

Hi Jul No problem at all. I always think that an explanation is only clear if it works for the person reading it. I am pretty well at the moment, following a mild dip earlier in the autumn which I think was probably a result of lots of change at work and having to get to grips with a new role. I know that you have an awful time with sleeping and I feel quite lucky not to have sleep problems too often. I hope you are also relatively ok at the moment. Love TF x

Jul Wed, Nov 30th 2016 @ 5:57pm

xxx Jul x

Wyvern Wed, Nov 30th 2016 @ 10:13am

Dear Mary
Thank you so much for the mental image of the Fens - especially on this crisp and frosty morning. I spent some years living on a boat over there; swapped it for the Kennet and Avon canal and a new job. I love the Fens, so open, fresh air, wild life, lots of space.
The K&A and Wiltshire is lovely too but in a different way. Lots more trees to get used to!
Now, medication. I'm all for it. I spent much of my life with low-level depression (dysthymia), never diagnosed as I never realised other people didn't feel the same. Crisis time, doctor, medication. Eventually Sertraline (interestingly, Citalopram made me worse) and now I've been taking it for maybe 3 years. Even though I now feel 'better', I still keep taking it, as I know that when I've tried not taking it I get worse again. Especially when something 'happens' that I find hard to cope with. Even with the tablets I can still get really low Moodscope scores at times.
I have also had counselling, CBT, courses and workshops of various ways to improve matters, all have helped, Moodscope most of all - the whole packet - scoring my moods, reading blogs, occasionally commenting ... :-)

Hopeful One Wed, Nov 30th 2016 @ 10:18am

Hi Mary - I enjoyed reading your blog with the vivid descriptions so much so that I felt I too was travelling along that road having once been to the Fens. There is no doubt that antidepressants are life savers and yes one may need to try several different ones before one finds a the right one.

A laugh helps too.

I couldn't find my luggage at the airport baggage area and went to the lost luggage office and reported the loss. The woman there smiled and told me not to worry because she was a trained professional and said I was in good hands. 'Now,' she asked me, 'has your plane arrived yet?'...

Jul Wed, Nov 30th 2016 @ 10:39am

Hi Hopeful One. I've been enjoying your recent jokes. I would like today's even more if the lost luggage office person had been a man Lol!!Or better still gender neutral.Anyway keep the jokes coming please and hope life is treating you well. Julxx

Hopeful One Wed, Nov 30th 2016 @ 4:22pm

I couldn't find my luggage at the airport baggage area and went to the lost luggage office and reported the loss. The operative behind the counter smiled and told me not to worry because the operative was a trained professional and said I was in good hands. 'Now,' the operative asked me has your plane arrived yet?'...

Jul Wed, Nov 30th 2016 @ 10:42am

Soon Hopeful One you will be so keen to be totally PC when giving us your jokes, you may find it's just not possible to put pen to paper. Apologies for being picky today. Just the way I'm feeling I think . Jul x

Hopeful One Wed, Nov 30th 2016 @ 4:26pm

Hi Jul - I think it's virtually impossible to be totally PC - I try my best!

Jul Wed, Nov 30th 2016 @ 5:56pm

Yes you do try your best. Thank you!It's an intellectual challenge. I was thinking "person" and s/he but it rolls off our tongues better with either a he or a she. I am so relieved you have replied to me as I worried I may have been petty where it really wasn't necessary. I have been thinking about it all afternoon!! Have a nice evening Hopeful One. Jul xx

Victoria Wed, Nov 30th 2016 @ 11:09am

Oh, that mesmerising pull. Entrancing sometimes, the tube platform, the river bridge, the cliff edge.
I loved your writing today. I'm pleased the medication is helping

Dee Wed, Nov 30th 2016 @ 11:24am

I have restarted taking citalapram - it is an important step to recovery I think, I live on the coast in Norfolk, I wish we could meet up, but am with you in spirit, Dee x

Lexi Wed, Nov 30th 2016 @ 12:00pm

So glad you are feeling and seeing things again Mary. Drugs are indeed glorious. After finding thr right one I feel like I can manage my moods without succumbing to the black water. Xo lexi

Dragonfly Wed, Nov 30th 2016 @ 1:31pm

Beautifully written Mary, just lovely. I take Escitalapram, which pulled me out of the pit of despair I was in some years ago - barely able to get out of bed and having lost my sense of identity. How I feel now is far from ideal, but I'm functioning and living, with intermittent sunshine. Thank you for your comment yesterday. Funny you suggest an orchid as I've been considering writing about my winter orchid for a while now, but I've felt unsure how to make it relevant here. Perhaps I'll just start writing and see what happens! x

the room above the garage Wed, Nov 30th 2016 @ 1:47pm

Wonderful Mary! I'm glad you are better even if you need to rest. Does staying on the meds all year round not work? Such a rollercoaster. Enjoyed this very much thank you, love ratg x.

Rebecca Wed, Nov 30th 2016 @ 3:45pm

I have been on citalopram for over ten years now. I find it a bit worrying but was suicidal before that. Increased dose this year but feel it helps me live a relatively normal life. Give myself hard time for living and relying on parents at 36 but manage to work.

The Gardener Wed, Nov 30th 2016 @ 4:39pm

My image of the fens is totally coloured (or grey) by Dorothy Sayers 'The Nine Tailors'. Somebody important in my political life was a big landowner up there. I opined that it was too flat and I had not seen a 'grand' house worthy of merit. He drove us about 100 miles to find an, admittedly, beautiful house. Don't like the Camargue either, same reason. Then somewhere spectacularly mountainous (like Corsica) I'm scared stiff. Slight negative thought - at my age I am constantly aware that my driving might be questionable, and I hope I will be aware soon enough that I am unsafe. Your driving on 'auto-pilot' and 'needing sleep' raises questions of the effect of your drug - having been so low last week recovery seems miraculous. Took Mr G for an eye check this morning, necessitating drops to dilate the pupils. The form says firmly 'come accompanied'. I know several men who still insist in driving home - even when they can't focus, and have a perfectly competent wife with them. Sorry, something I am almost paranoiac about. Hope progress continues. Thanks for your compliment yesterday.

Tutti Frutti Wed, Nov 30th 2016 @ 6:36pm

Gardener I think you have a good point about being careful about driving. I guess as long as Mary's team haven't suggested she shouldn't drive she is probably OK. My team have sometimes advised me not to drive for a while following an episode so I think this is something that they do consider. Hope you are doing OK today. Love TF x

Mary Wednesday Wed, Nov 30th 2016 @ 9:56pm

I too love The Nine Tailors. I don't drive if I feel I am unsafe. My husband, for instance, drove today because I was shaking. And the drugs were lifting me for the last week. The dark blogs were all written over a period of three days when I first fell off that cliff. But, with my kind of bipolar, the switch from state to state tends to be pretty rapid anyway!

Jul Wed, Nov 30th 2016 @ 6:02pm

You have just made me laugh Gardener. I like the horses in the Camargue but have only driven through I think. And I did see many lovely horses running wild then. I am scared of Corsica too and anywhere too mountainous. We are currently in our house in Limousin. A much maligned part of France. I am glad you had a respite day yesterday. Love Jul xx

The Gardener Wed, Nov 30th 2016 @ 7:13pm

Only know the lovely Limousin cattle - favourites after Saler. Many understated departments in France - Correze being one. Awful time - took Mr G to eye specialist. He destroys me with perpetual insisting that his sight is much worse (than when - and how does he measure) that 'I can't see a thing'. All our lights are always wrong, we are now very unwelcome visitors as he has no compunction in grumbling about our hosts heating and lighting. The excellent specialist assured us no deterioration - thought we could both be re-assured - but Mr G did not even listen to the Doctor and has been persecuting me the whole afternoon, every 2 minutes, 'where are you'. If he asks the way to the toilet, and I say 'you can see it' he flies into a rage. That's Alzheimers for you.

E Wed, Nov 30th 2016 @ 7:59pm

What are peoples thoughts on the longterm use of antidepressants? I have been reading conflicting information on their use at a “maintenance” dose from the established view that taking antidepressants to treat a recurrent depressive disorder is like taking thyroxine to treat an under active thyroid, to antidepressants are effective in the short term but loose their effectiveness over the long term, to antidepressants are no better than a placebo and it is all a giant conspiracy got up by the drug companies to make a profit, to antidepressants are actively harmful and cause more problems than they solve and should be avoided at all costs and it is all a giant conspiracy got up by the drug companies to make a profit.

Tychi's Mum Thu, Dec 1st 2016 @ 4:02am

E, I too feel confused with all of the conflicting views of the pros and cons of antidepresants. I believe that you can only form an opinion based on your own experience.
When I first became depressed I was prescribed Citalopram which suited me really well. I felt great on it. I took it for a year but due to stressful life events during that time, had to increase the dose from 20mg to 40mg. After a year my GP put me under pressure to come off the medication. I "crashed". Severe depression enveloped me once again. I dearly wish I'd never come off the Citalopram and have a sneaking suspicion that I would still be stable now if I'd remained on it. A lesson for me...go with your gut feeling. Your GP isn't necessarily right.
I am now three years further along my journey. I have only just been diagnosed with recurrent depressive disorder but I'm convinced that I have low level bi-polar. I am now on my fourth medication and for the past three yaers I have been yo-yoing between "slightly high" and "severely low" mood. My team are still working to find the right medication at the right dose to keep me stable. I remain hopeful that we'll get there...but they are very dismissive of the bi-polar idea. Again....they are not always right.
I was reluctant to take medication in the beginning but I now embrace it entirely. Once I become stable I plan to remain on the medication. Coming off the Citalopram and subsequently "crashing" has taught me that I NEED to be on medication. Without it my brain chemicals totally put it mildly...
I hope that you find this helpful E.
Tychi's Mum

E Thu, Dec 1st 2016 @ 12:23pm

Dear TM, Thanks for responding. When your GP put pressure on you to come off Citalopram was that your first depressive episode? My storey is slightly different, after repeated episodes of depression in my early 20‘s which were all successfully treated with Prozac and following a particularly bad episode 10 years ago I went back on the Prozac and stayed on it at what I would describe as a maintenance dose of 20mg. All was well, and like you I embraced Prozac as the wonder drug it appeared to be. But for the past year I felt that the Prozac had not been doing its thing and I was slipping back into the glass half empty person I was in my pre- Prozac days. Then 3 months ago, bang!, apparently out of the blue I crashed. Now I am on 40mg Prozac and 30mg of Mirtazipine and have only made a partial recovery at best. My confidence in anti-depressant medication has been severely shaken to say the least but I find your example reassuring. Perhaps I need to give the med’s more time but I am not looking forward to embarking on a game of medication roulette in the hope of finding a new antidepressant or combination of medications that is going to work as well as the Prozac once appeared to either. I am however looking to go into some form of therapy as well. I would be wary of seeking a diagnosis of bi-polar disorder if I was you. Mood stabilisers, the preferred medication of choice for bi-polar, have many more and far more serious side effects than antidepressants although if you are right it is possible the Citalopram may be contributing to the manic highs. From the way you describe it the “highs” are not too high and could be managed with CBT perhaps? Good luck with getting an accurate diagnosis and the right treatment Dear Gardener, Thank you for responding as well. There are many conflicting ideas and theories about how and even if antidepressant medication works and sorting the good from the bad is difficult to say the least for even the best informed consumer. When I was at my lowest, a couple of months ago, I made the mistake of reading a lot of very alarmist stuff on the internet, (try googling “does Prozac give you brain damage?” and you will see what I mean). The trouble any commentator has in raising concerns about psychiatric medication is they find themselves up against the weight of received opinion backed first by the Psychiatric profession and then the pharmaceutical industry and are often written off like they are the equivalent of climate change deniers. Like you I hope we have learnt the lessons with regard to Valium and are not about to repeat them with drugs like Prozac. I have come a little late to this discussion but I have submitted a blog raising the question of medication and the part it has or not played in peoples recovery so perhaps we can have a fuller discussion then.

The Gardener Thu, Dec 1st 2016 @ 10:47am

To those worried about long-term use - most 'experts' and drug companies themselves advise regular reviews on drug use - still useful? causing dependence? is their something better? do you need them at all? There was a film/book - Dancing with Vallium? all about dependence. Our long-term family doctor, a most modern and forward thinking man, gave me repeat prescriptions for Vallium for years - certainly I'd been manic, but, really, it was my life I needed to look at not stay permanently one step ahead of zombie-ism. This doctor had an accident - one of the partners took over - excellent but no-nonsense Scot (how I appreciated his attitude to authority when my mother was dying). I went for a prescription - what for? Vallium. Why? Well, I always have Vallium. Doc, not any more you're not. And I did NOT need it.

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